• By Dennis Douda

Testing Heart Patients’ Genes for Best Drug Choice

November 13, 2013

Mayo Clinic Studying Genomics of Antiplatelet Heart Medication

Each year in the United States, 600,000 to 800,000 heart stents are placed to restore blood flow through coronary arteries. Patients are then given medication to keep blood clots from forming near the surgical site. Such clots can be deadly, causing heart attack and stroke.

But, which antiplatelet medication is best? The answer may lie in your genes. “The current standard of care after angioplasty is to prescribe clopidogrel for one year, regardless of a person’s individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug,” says Naveen Pereira, M.D., a Mayo Clinic cardiologist and principal investigator.

Click here to read the full news release.

Journalists: Sound bites with Dr. Pereira and animation of a heart stent placement are available in the downloads.

/// Sound bite - Very Common Problem - (Naveen Pereira, M.D., Mayo Clinic Cardiologist)   “And so one-third of patients, and up to 50 percent of Asians, have this genetic variance where this enzyme doesn’t work well. And so if this enzyme doesn’t work well, what happens is the inactive drug of clopidogrel, or Plavix, is not converted to the active drug.”

Alternative antiplatelet medications are sometimes far more costly and carry potentially risky side effects. It's an issue that's prompted some professional cardiovascular societies and many working cardiologists to question the U.S. Food and Drug Administration’s recent recommendation that patients undergo genetic testing before taking Plavix (clopidogrel bisulfate).

/// SOT - Study Goal - (Naveen Pereira, M.D., Mayo Clinic Cardiologist) So what we are seeking is trying to figure out which patients will respond to the best type of antiplatelet drugs to prevent them from having problems after they have a stent placed.

The Tailored Antiplatelet Therapy to Lessen Outcomes after Percutaneous Coronary Intervention (TAILOR-PCI) Study,  is the first prospective, randomized, scientific study to address this issue and was launched this summer by the Center for Individualized Medicine and the Division of Cardiovascular Diseases at Mayo Clinic. The two-year study of Plavix and Brilinta will include approximately 5,300 patients from 15 hospitals worldwide. Beyond answers regarding antiplatelet medications, researchers expect to gather a wealth of information about how our genes affect our heart health.

/// SOT - Creating Huge Bio bank - (Naveen Pereira, M.D., Mayo Clinic Cardiologist)  “But the other wonderful part of this study is that we’ll have the DNA in over 5,000 patients and then we’ll be able to analyze the DNA, not only for looking as to what genetic markers identify patients who respond to Plavix and aspirin, but other drugs and also trying to look for genetic variance that are associated with heart disease and coronary artery disease in general.”